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Certificate Preview Wind close when finished REIREINEDPage <br /> 1 of 1 <br /> Certificate Preview <br /> 0 4A3 e DATE <br /> ACCOR" CERTIFICATE OF LIABILITY (MM/DD/YYYY) <br /> EUVRON M E 6 gg L HEAL 03/28/2017 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 0 <br /> DER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVEY AMEND, TEND OR ALTER T E COVE A O POLICIES BELOW.THIS <br /> CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR <br /> PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the <br /> terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> Producer CA LIC OB29370 P:1-925-244-7700 CONTACT <br /> NAME:Certificates Department <br /> Edgewood Partners Insurance Centers(EPIC)[San Ramon-Branch ID 143941 — <br /> P.0.Box 5003 PHONE FAX <br /> (A/C,No.Ext):(925)244-7700 I(A/C,No):(925)901-0671 <br /> San Ramon,CA 94583 E-MAIL <br /> Agent: ADDRESS:EPICcerts@EPICBrokers.com <br /> Insured INSURER(S)AFFORDING COVERAGE NAIL# <br /> Gettler-Ryan Inc. Insurer A:I WESTCHESTER SURPLUS LINES INS CO 10172 <br /> 6805 Sierra Court,Suite G Insurer B: WEST AMER INS CO 44393 <br /> Insurer C: STATE COMPENSATION INS FUND 35076 <br /> Dublin,CA 94568 <br /> Insurer D: OHIO SECURITY INS CO 24082 <br /> Insurer E: <br /> Insurer F: <br /> COVERAGES CERTIFICATE N NUMBER:49443377 REVISIONUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING AN <br /> REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANC <br /> AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID <br /> CLAIMS. <br /> ns Type of Insurance Add'ISUBR Policy Number Policy Policy Limits <br /> tr lnsrcVIVD Effective Expiration <br /> _ (MM/DD MM/DD <br /> A GENERAL LIABILITY G2401448401 04/01/17 04/01/18 Each Occurrence 1,000,00 <br /> IXI Commercial General Liability Damage to Rented <br /> 11 Claims Made IXI Occur Premises(Ea <br /> 1X1$2,500 Ded/Occ occurrence) $$50,000 <br /> 11 Med Exp (Anyone <br /> Gen'I Aggregate Limit Applies Per: person) 5 000 <br /> 11 Policy I X I Project I I Loc Personal&Adv <br /> In Lr 1,0_00,00 <br /> General 89gregate <br /> 20 000 <br /> Products-Comp/Op <br /> A99 2 000 00 <br /> B AUTOMOBILE LIABILITY BAW57348304 04/01/17 04/01/18 Combined Single <br /> 1X1 Any Auto Limit Ea accident 100000 <br /> 11 Ail Owned Autos I I Scheduled Autos Bodily Injury (Per <br /> 1X1 Hired Autos 1X1 Non-Owned Autos erson <br /> I I Bodily Injury (Per <br /> accident <br /> Property Damage <br /> Per accident <br /> A I I UMBRELLA LIAB IXI OCCUR G2401450201 04/01/17 04/01/18 Each Occurrence 5 000 00 <br /> 1X1 EXCESS LIAB II CLAIMS MADE <br /> Aggregate 5 000 00 <br /> II DEDUCTIBLE 1X1 RETENTION $ 0 <br /> C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY N/A 90512292017 04/01/17 04/01/18 WC <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?Y/N IXIStatutoryl 10the <br /> (Mandatory in NH) Y Limits <br /> If yes,describe under DESCRIPTION OF OPERATIONS below E.L.Each Accident 1,000 00 <br /> E.L.Disease-Ea <br /> Employee INCLUDED <br /> E.L.Disease-Policy <br /> Limit NCLUDED <br /> OTHER <br /> A <br /> Professional Liability G2401448401C 04/01/17 04/01/18 $iM Per Claim $Ded/SO <br /> A Pollution G2401448401 04/01/17 04/01/18 $1M Per OCC $Ded10 <br /> D Rented Leased E ui ment BKS57251051 .2:L"117 04/01/18 100K Per Item Ded 2 50 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Proof of Insurance <br /> CERTIFICATE HOLDER CANCELLATION <br /> *EVIDENCE OF COVERAGE* SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE <br /> WITH THE POLICY PROVISIONS. <br /> Authorized Representative <br /> Brian F.Quinn <br /> cward @ 1995-2010 ACORD CORPORATION.All rights reserved. <br /> 49443377 <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br /> Close Window <br /> https://certificatesnow.confirmnet.com/Common/certificatePreview jhtml,jsessionid=OKB... 4/28/2017 <br />